Grief is a natural response to losing a loved one. Individuals experience loss in a variety of contexts and situations. How one grieves and feels the loss of a loved one is unique to them. A loss during pregnancy and/or of an infant (also known as perinatal loss) is a life-changing experience that profoundly affects individuals, including their identity, relationships, and sense of worth and belonging. This type of loss can include miscarriage, termination due to medical reasons, stillbirth, or infant death.
When facing grief and loss, it is important to remember that grief can manifest in many ways, depending upon the individual’s experience of grief and where they are in the grieving process.
5 Stages of Grief
- Denial – buffering the initial shock of a loss.
- Anger – releasing bottled-up emotions.
- Bargaining – trying to find meaning.
- Depression – realizing the inevitable/reality.
- Acceptance – moving forward.
These 5 stages are non-linear as individuals can experience these aspects of grief at different times, they do not necessarily happen in one order and individuals might not experience all of the stages.
An individual transitions into the role of a parent and develops an attachment to their baby during pregnancy. Perinatal loss can lead to the loss of one’s identity as a parent, resulting in feelings of numbness and disconnect. Grief can affect all aspects of the person, whether that is physical, emotional/mental, spiritual and/or social factors. Physical and emotional aspects are typically the most common experiences or “symptoms” of grief.
 Kubler-Ross, D., & Kessler, E. (2014). On grief and grieving. Simon & Schuster.
 Koopmans, L., Wilson, T., Cacciatore, J., & Flenady, V. Support for mothers, fathers and families after perinatal death.
 Côté-Arsenault, D. & Comerford, F.M. Loss and grief in the childbearing period. 2nd ed. White Plain (NY): March of Dimes; 2011.
 Hutti, M.H. Social and professional support needs of families after perinatal loss. J Obstet Gynecol Neonatal Nurs. 2005;34(5):630-8.
- Joint pain
- Stomach pain
- Difficulty breathing / chest tightness
- Fatigue/lack of energy
- Decreased or increased appetite
- Difficulty sleeping
- Sense of identity loss
- Detachment/absence of emotion
- Guilt / self-blameIsolation / feeling alone
- Isolation/ feeling alone
Sometimes, an individual’s experience of grief can be so overwhelming that they find it difficult to cope with or engage in the demands of daily living. This is where occupational therapy can provide support to help individuals navigate all stages of the grieving process alongside the intense physical and/or emotional distress associated with pregnancy or infant loss.
Occupational Therapy Role in Coping with Grief & Loss
Occupational therapy (OT) is a client-centred health profession focused on promoting health and well-being through everyday activities. The primary goal of occupational therapy is to enable people to participate in meaningful activities, routines, and roles – also known as occupations. Occupational therapists use meaningful activities to help individuals participate in what they need and want to do to promote physical and mental well-being.
OTs focus on participation in the following areas: social/leisure participation, activities of daily living (ADLs) (e.g., eating, dressing, hygiene), instrumental activities of daily living (IADLs) (e.g., meal preparation, household management), sleep, and work.
Impact of Grief & Loss on Daily Life
- Social Participation – behavioural changes such as irritability, social withdrawal, etc.
- ADLs & IADLs – changes in one’s appetite, neglecting self-care, lack of hygiene practices (i.e., not showering or changing clothes), engaging less in habits and routines, etc.
- Sleep – disrupted sleep habits, chronic fatigue/low energy levels, insomnia, etc.
- Education/Work – difficulty following directions or concentrating on tasks, changes in overall performance, and challenges in assuming responsibility, etc.
It is crucial for individuals to learn appropriate coping strategies to promote healthy grieving. OTs can support the care and well-being of individuals experiencing loss and grief as they are equipped with the skills and knowledge to help individuals reflect, cope, and grow around their grief.
Growing Around Grief
This perspective of grief acknowledges that individuals can still grieve the loss of a loved one while carrying on with their own lives. It shows that individuals can grow a life which copes with this unimaginable loss but does not suggest that grief will go away over time or at all.
There will be some days when the grief will feel as strongly as it did when the loss first occurred and there will be days when individuals will be able to move forward with other parts of their life.
“Grief is like the ocean; it comes on waves ebbing and flowing. Sometimes the water is calm, and sometimes it is overwhelming. All we can do is learn to swim.”
– Vicki Harrison
This quote represents grief as a feeling, an emotion, and a state of mind that lives with us even long after our loved ones have left us. It motivates us to grow around our grief. Learning to swim does not mean forgetting our loss and grief, but rather acknowledging that moving forward involves reflecting, embracing all our emotions, and getting back to the activities and routines that give us pleasure and happiness.
It may be hard to see or recognize a life where grief isn’t at the forefront but remember that it is okay because grief does not have an expiry date. If you ever find yourself feeling “stuck” in your grief and not knowing how to move forward, please know that there is and will always be support. You don’t need to face your hardships alone.
Sabrina Teles and Sofia Mirzazada are Occupational Therapists at Tripod Fertility. They support the well-being of clients and couples throughout their fertility journey (preconception, pregnancy, and postpartum).